Two-Step Screening for Depressive Symptoms and Prediction of Mortality in Patients With Heart Failure

2017 ◽  
Vol 26 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K. Moser ◽  
Michele Pelter ◽  
Martha J. Biddle ◽  
Kathleen Dracup
Keyword(s):  
Heart Failure ◽  
Depressive Symptoms ◽  
Hazard Ratio ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Step Method ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Patient Health

Background Comorbid depression in patients with heart failure is associated with increased risk for death. In order to effectively identify depressed patients with cardiac disease, the American Heart Association suggests a 2-step screening method: administering the 2-item Patient Health Questionnaire first and then the 9-item Patient Health Questionnaire. However, whether the 2-step method is better for predicting poor prognosis in heart failure than is either the 2-item or the 9-item tool alone is not known. Objective To determine whether the 2-step method is better than either the 2-item or the 9-item questionnaire alone for predicting all-cause mortality in heart failure. Methods During a 2-year period, 562 patients with heart failure were assessed for depression by using the 2-step method. With the 2-step method, results are considered positive if patients endorse either depressed mood or anhedonia on the 2-item screen and have scores of 10 or higher on the 9-item screen. Results Screening results with the 2-step method were not associated with all-cause mortality. Patients with scores positive for depression on either the 2-item or 9-item screen alone had 53% and 60% greater risk, respectively, for all-cause death than did patients with scores negative for depression after adjustments for covariates (hazard ratio, 1.530; 95% CI, 1.029–2.274 for the 2-item screen; hazard ratio, 1.603; 95% CI, 1.079–2.383 for the 9-item screen). Conclusions The 2-step method has no clear advantages compared with the 2-item screen alone or the 9-item screen alone for predicting adverse prognostic effects of depressive symptoms in heart failure.

scholarly journals Reliability and construct validity of the modified Finnish version of the 9-item Patient Health Questionnaire, and its’ content validity within biopsychosocial frame among female healthcare workers with sub-acute or recurrent LBP

2019 ◽  
Author(s):  
Jaana Helena Suni ◽  
Tarja Virkkunen ◽  
Pauliina Husu ◽  
Kari Tokola ◽  
Jari Parkkari ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Construct Validity ◽  
Internal Consistency ◽  
Content Validity ◽  
Healthcare Workers ◽  
Bodily Pain ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Increased Risk ◽  
Patient Health

Abstract Background: Healthcare workers have increased risk for chronic low back pain (LBP) leading to reduced workability. Depression, a highly prevalent, costly and disabling condition, is commonly seen in patients with sub-acute LBP. This study investigated the psychometric properties and content-validity of a modified 9-item Patient Health Questionnaire (PHQ-9-mFIN) in female healthcare workers with sub-acute LBP. Methods: Reliability (internal consistency, test-retest repeatability) was assessed with standard methods. Construct validity of the PHQ-9-mFIN was assessed as level of depression (PHQ-9-mFIN: 0-4 none, 5-9 mild, ≥10 at least moderate) against RAND-36 Health Survey, a valid measure of health-related quality of life (HRQoL). Content validity was determined as the strength of the association between the levels of PHQ-9-mFIN and the selected biopsychosocial factors. Results: The internal consistency of the PHQ-9-mFIN was high (Cronbach’s α=0.82) and the test-retest repeatability scores (n=65) fair: Pearson’s correlation 0.76, Kappa-value 0.42 for the diagnostic criterion (i.e. scores 0-9 vs. 10-27). Construct validity (Spearman correlation) against the Physical and Mental component items and their summary scales of the RAND 36 were much higher for the Mental (range -0.43 to -0.70 and -0.68) than for the Physical (range -0.06 to -0.41 and -0.24), respectively. There was a clear stepwise association (p<0.001) between the levels of depressive symptoms and General health (physical component, range 59.1 to 78.8). The associations with all items of the Mental components were strong and graded (p<0.001). All participants had low scores for Bodily pain regardless of the level of depressive symptoms. There was a strong association (p≤0.003) between levels of PHQ-9-mFIN and multisite pain, lumbar exertion and recovery after work days, neuromuscular fitness in Modified push-ups, workability, and fear of pain related to work. Conclusions: The PHQ-9-mFIN showed adequate reliability, and excellent construct and content validity among female healthcare workers with recurrent LBP and physically strenuous work. Trial registration: NCT01465698

Measuring Depressive Symptoms in Heart Failure: Validity and Reliability of the Patient Health Questionnaire-8

2010 ◽  
Vol 20 (2) ◽  
pp. 146-152 ◽  
Author(s):  
S. J. Pressler ◽  
U. Subramanian ◽  
S. M. Perkins ◽  
I. Gradus-Pizlo ◽  
D. Kareken ◽  
...  
Keyword(s):  
Heart Failure ◽  
Depressive Symptoms ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Validity And Reliability ◽  
Patient Health

scholarly journals Patient Health Questionnaire-2 Screening for Depressive Symptoms in Japanese Outpatients with Heart Failure

2019 ◽  
Vol 58 (12) ◽  
pp. 1689-1694
Author(s):  
Tsuyoshi Suzuki ◽  
Tsuyoshi Shiga ◽  
Katsuji Nishimura ◽  
Hisako Omori ◽  
Fujio Tatsumi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Depressive Symptoms ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health

Psychometric Properties of the Patient Health Questionnaire-9 in Patients With Heart Failure and Gastrointestinal Symptoms

2014 ◽  
Vol 22 (2) ◽  
pp. 29E-40E
Author(s):  
Eun Jin Lee ◽  
Lynne A. Hall ◽  
Debra K. Moser
Keyword(s):  
Heart Failure ◽  
Concurrent Validity ◽  
Gastrointestinal Symptoms ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Gi Symptoms ◽  
Patients With Heart Failure ◽  
Patient Health

Background and Purpose: Patients who have coexisting medical conditions tend to be more depressed. The purpose of this study was to examine the reliability, validity, and dimensionality of the Patient Health Questionnaire-9 (PHQ-9) in patients with heart failure and gastrointestinal (GI) symptoms. Methods: The cross-sectional data for this secondary analysis were collected in four studies. Cronbach's alpha was used to examine reliability. Concurrent validity with the Beck Depression Inventory-II (BDI-II) was examined. Results: Cronbach's alpha for the PHQ-9 was .87. Concurrent validity with BDI-II was excellent (r = .78, p < .01). Conclusions: The evidence from this study supports the reliability and validity of the PHQ-9 as a measure of depression in patients with heart failure and GI symptoms.

scholarly journals Prediction of all-cause mortality with malnutrition assessed by controlling nutritional status score in patients with heart failure: a systematic review and meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Huiyang Li ◽  
Peng Zhou ◽  
Yikai Zhao ◽  
Huaichun Ni ◽  
Xinping Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Nutritional Status ◽  
Meta Analysis ◽  
Predictive Values ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Conut Score

Abstract Objective: The aim of this meta-analysis was to investigate the association between malnutrition assessed by the controlling nutritional status (CONUT) score and all-cause mortality in patients with heart failure. Design: Systematic review and meta-analysis. Settings: A comprehensively literature search of PubMed and Embase databases was performed until 30 November 2020. Studies reporting the utility of CONUT score in prediction of all-cause mortality among patients with heart failure were eligible. Patients with a CONUT score ≥2 are grouped as malnourished. Predictive values of the CONUT score were summarized by pooling the multivariable-adjusted risk ratios (RR) with 95 % CI for the malnourished v. normal nutritional status or per point CONUT score increase. Participants: Ten studies involving 5196 patients with heart failure. Results: Malnourished patients with heart failure conferred a higher risk of all-cause mortality (RR 1·92; 95 % CI 1·58, 2·34) compared with the normal nutritional status. Subgroup analysis showed the malnourished patients with heart failure had an increased risk of in-hospital mortality (RR 1·78; 95 % CI 1·29, 2·46) and follow-up mortality (RR 2·01; 95 % CI 1·58, 2·57). Moreover, per point increase in CONUT score significantly increased 16% risk of all-cause mortality during the follow-up. Conclusions: Malnutrition defined by the CONUT score is an independent predictor of all-cause mortality in patients with heart failure. Assessment of nutritional status using CONUT score would be helpful for improving risk stratification of heart failure.

scholarly journals The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhiliang Zhang ◽  
Chao Chang ◽  
Yuxin Zhang ◽  
Zhiyong Chai ◽  
Jinbei Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chinese Population ◽  
Selenium Concentration ◽  
Chinese Patients ◽  
Serum Selenium ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Serum Selenium Concentration ◽  
Baseline Information

AbstractWhether Selenium (Se) deficiency relates with adverse prognosis in Chinese patients with heart failure (HF) is still unknown. This study aimed to investigate the association of serum Se level and the outcomes of patients with HF in a Chinese population. Patients with HF and serum Se examination were retrospectively included. Baseline information were collected at patient’s first admission. The primary and secondary outcomes were all-cause mortality and rehospitalization for HF during follow-up, respectively. The study participants were divided into quartiles according to their serum Se concentrations. The Cox proportional hazard models were adopted to estimate the association of serum Se levels with observed outcomes. A total of 411 patients with HF with a mean age of 62.5 years were included. The mean serum level of Se was 68.3 ± 27.7 µg/L. There was nonsignificant difference of baseline characterizes between the four quartile groups. In comparison with patients in the highest quartile, those with the lowest quartile (17.40–44.35 µg/L) were associated with increased risk of all-cause mortality [adjusted hazard ratios (95% CI) 2.32 (1.43–3.77); Ptrend = 0.001]. Our study suggested that a lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with HF.

scholarly journals Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
María Urtasun ◽  
Federico Manuel Daray ◽  
Germán Leandro Teti ◽  
Fernando Coppolillo ◽  
Gabriela Herlax ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Convergent Validity ◽  
Patient Health Questionnaire ◽  
Receiver Operating Curve ◽  
Local Version ◽  
Health Questionnaire ◽  
Good Ability ◽  
Patient Health ◽  
Severity Of Depression ◽  
Degrees Of Severity

Abstract Background The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. Methods We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. Results One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach’s alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson’s correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6–8 for mild cases, 9–14 for moderate and 15 or more for severe depressive symptoms respectively. Conclusions The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.

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